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INNOVATION & ENTREPRENEURSHIP Jennifer Good and Trevi erapeutics bank on an innovative alternative to addictive opioids Easing the Pain By Melissa Nicefaro O ne of the biggest public-health crises in American was starting to unfold, and Jennifer Good wanted to be part of a solution. Opioids were effective at treating chronic pain from disease and injury, but the risk of addic- tion was proving to be greater than experts had foreseen. Good thought there had to be anoth- er alternative to help patients dealing with pain and related symptoms. "at was the whole genesis," Good explains. "It was about trying to be part of the solution around the opioid crisis and deal- ing with that biological system in the body that seemed to have a lot more biological reach than just pain." Armed with a great idea and a strong possibility to improve the quality of life for many dealing with chronic neurologi- cally mediated conditions, Good entered territory not yet traveled. She and her former colleague Tom Sciascia set out to chart and navigate the regulatory path for a new clinical-stage biopharma- ceutical company called Trevi erapeutics, which developed Nalbuphine ER, an oral drug for pain and disease that has less addictive long-term safety profile. Nalbuphine mitigates the risk of abuse associated with mu opioid agonists because it blocks the mu opioid receptor. is May that new compa- ny raised $70 million in gross proceeds from an initial public offering (Trevi's stock now trades on the Nasdaq exchange under the ticker symbol TRVI) and concur- rent private placement. With a rich background in drug development, Good was previ- ously CEO of Penwest Pharma- ceuticals in Danbury, which was acquired by Endo Pharmaceuticals in 2010. In 2011, she and Sciascia, Penwest's chief medical officer, started Trevi erapeutics, head- quartered at 195 Church Street in downtown New Haven. "e whole opioid crisis was going on around us, and we were developing a pain management drug with Endo," Good recounts. "We'd co-developed it with them, the drug was approved, and Endo ended up acquiring that company." "But there were a couple of things going on in my mind: the opioid crisis was real and I wanted to be part of that solution." She put her plan into action and developed an oral drug called Nalbuphine ER. "It works biologically by block- ing the new receptors, which is where addiction happens, but with minimal side effects," Good ex- plains. "You get the benefits of opi- oids with good long-term safety, but you don't have the addiction. So that was intriguing." Nalbuphine ER has a dual mechanism of action, acting as both an antagonist (blocker) to the body's mu opioid receptor and as an agonist (activator) to the kappa opioid receptor. e kappa and mu opioid receptors are known to be critical mediators of the urges to scratch and cough, as well as of certain movement disorders. e other thing Good found in- triguing is that one of the reasons opioids are so useful, is that the body is loaded with endogenous opioid, going throughout all of the Good realized that 'The opioid crisis was real, and I wanted to be part of that solution.' 22 n e w h a v e n B I Z | S e p t e m b e r / O c t o b e r 2 0 1 9 | n e w h a v e n b i z . c o m

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